Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Access Problems

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When patients require specific therapies and an insurance company makes the frail or sickly patients jump thru hoops, denying or delaying care, it's time to move away from the insurance model.   How furious should we be when the insurer uses technicalities to refuse coverage, makes patients wait incessantly on the phone, transfers calls to G_d knows now many departments and then, after seemingly hours, the connection breaks, etc.?

Healthcare Reform/Economic Imperative

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Is health care reform merely cost-minimization, an opaque attempt to force economic responsibility? Simplifed, Here's the essence of health care reform and how to restore equity in access.... 1)    To reform care we must manage the care a)   The fact that delivery models vary or that they are evolving should not distract us from our goal to have effective care that is efficient and thereby cost-effective.  At the end of the day, however, it must be about the patient!

Cancer and Nutrition

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It's often difficult to maintain a good appetitie and nutritional status when fighting cancer. Here are some tips from cancer experts and dietitians that may help: Fresh ginger (not ginger flavoring), taken about 1/2 hour before eating can lessen or even eliminate nausea, but  common in many sodas. Eat more protein and less fat and/or fiber; eat smaller meals more frequently throughout the day--maybe 5-6 Drink more between meals than during them

Ear Wax

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The use of a bulb syringe at home may help relieve earwax blockage more effectively than a professional ear irrigation procedure. 240 adults in the U.K. got either ear drops and a bulb syringe to use at home or ear drops and then irrigation by a clinic nurse. Patients were reassessed after 2 weeks, and those with persistent blockage had their ears irrigated professionally.

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Timely or Delayed Breast Cancer Decision-Making

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"[Is] it true that early detection/screening will save your life? The answer to this is complicated, in part, because not all cancers are the same. In general, it is likely that screening will detect slow growing tumors better than fast growing ones. My favorite analogy is of a building with a security guard that takes an hour to circle the building.

The Real Cost of Not Immunizing

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Measles is back and people will be getting ill, harmed or worse because someone is refusing immunizations. OTOH, routine childhood immunizations may reduce the risk of leukemia. [1]

Obesity in Kids

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Adolescent obesity is a growing problem that causes consternation for all and for which there are few if any durable treatments available.  Non-treatment, however, is no option. Obese children, like their adult counterparts can develop metabolic syndrome with all of its attendant complications-- cardiovascular problems resulting from years of high blood sugar and lipid levels and consequent, diabetes and/or hypertension [1]. Pediatric Metabolic Syndrome May Not Be a Stable Diagnosis

Patient-Centered Caring

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Achieving patient-centered care is difficult, but essential; since paternalism is out, the patient has a greater role to play. The editorial, "Patient-Centered Care; What Is the Best Measuring Stick?" by Drs.